Night-time Rise in Blood Pressure Doubles the Risk of Death in Adults With Diabetes

Double risk of death in adults with diabetes is associated with rising blood pressure at night.

Twice the risk of death is associated with rising blood pressure at night, in adults with type 1 or type 2 diabetes as per a 21-year study presented at the American Heart Association Hypertension Scientific Sessions 2021.

Generally, the blood pressure declines or dips, while sleeping. If the BP does not decrease, it is termed as “non-dipping. Moreover, if the BP increases at night when compared to daytime, it is referred to as “reverse dipping.”

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These abnormal patterns of blood pressure increase the risks of various cardiovascular complications as well in adults with type 1 or type 2 diabetes.

“Previous studies have shown that non-dipping is linked to kidney and cardiovascular disease in healthy individuals and people with hypertension, or type 1 or type 2 diabetes. However, the long-term effects of non-dipping on death among people with diabetes remain unclear, and information on reverse dippers is extremely scarce. We sought to investigate these two aspects to highlight whether altered patterns of blood pressure might predict mortality risk in people with type 1 or type 2 diabetes,” says study author Martina Chiriacò, M.D., an investigator in the department of clinical and experimental medicine at the University of Pisa in Pisa, Italy.

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The study was conducted on 349 adults with diabetes in Pisa, Italy from 1999-2020. Among them, 50% were women, almost 284 had type 2 diabetes and 65 had type 1 diabetes. Deaths during the 21-year follow-up period accounted for 136 cases.

Moreover, among the participants, 82% had hypertension and 73% had uncontrolled hypertension.

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It was found that more than half of the participants had non-dipping blood pressure during the night, and 20% were reverse dippers. Moreover, one-third of reverse dippers had cardiac autonomic neuropathy versus 11% of those who had no dips.

Reduced survival to an average of 2.5 years was seen in reverse dippers and an average of 1.1 years in non-dippers when compared to dippers. In addition, reverse dippers had a more than two-fold increase in overall death risk.

“Our study shows that 1 in 10 people with type 1 or type 2 diabetes could be a reverse dipper, and that this condition likely more than doubles the risk of death from any cause over 21 years’ time, regardless of blood pressure control. It is important that health care professionals look for abnormal blood pressure dipping patterns in people with type 1 or type 2 diabetes. There are strategies to reduce blood pressure during the night. We support using this screening to optimize treatment for people with diabetes,” says Chiriacò.

Source-Medindia